Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

#1716 of 11K

J9310

HCPCS Procedure Code

HCPCS code J9310 is the #1,716 most-billed Medicaid procedure code, with $15.5M in payments across 6K claims from 2018–2024. The national median cost per claim is $2,163.51. Costs vary widely — the 90th percentile is $4,370.64 per claim, 2.0× the median.

Total Paid

$15.5M

0.00% of all spending

Total Claims

6K

Providers

47

Avg Cost/Claim

$3K

National Cost Distribution

How much do providers bill per claim for J9310? Based on 45 providers billing this code nationally.

Median

$2,163.51

Average

$2,318.99

Std Dev

$1,656.37

Max

$7,865.70

Percentile Distribution (Cost per Claim)

p10
$534.12
p25
$1,000.49
Median
$2,163.51
p75
$3,261.23
p90
$4,370.64
p95
$4,854.74
p99
$6,687.20

50% of providers bill between $1,000.49 and $3,261.23 per claim for this code.

90% bill between $534.12 and $4,370.64.

Top 1% bill above $6,687.20.

About This Procedure

HCPCS code J9310 was billed by 47 providers across 6K claims, totaling $15.5M in Medicaid payments from 2018–2024. This code was used for 3K unique beneficiaries.

Fraud Risk Context

Injectable drug codes carry high per-claim costs and have been involved in drug diversion and upcoding schemes.

Source: HHS OIG Reports

Risk Assessment

Billing Statistics

Median Cost/Claim

$2,163.51

Providers Billing

45

National Spending

$15.5M

Avg/Median Ratio

1.07×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for J9310

#ProviderTotal Paid
1Hmh Hospitals Corporation

Hackensack, NJ · Ambulance

$2.7M
2Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$2.6M
3Regents Of The University Of California

San Diego, CA · General Acute Care Hospital

$1.4M
4Regents Of The University Of Michigan

Ann Arbor, MI · Clinic/Center, End-Stage Renal Disease (ESRD) Treatment

$816K
5Unm Hospital

Albuquerque, NM · General Acute Care Hospital

$699K
6University Of California Irvine

Orange, CA · General Acute Care Hospital

$662K
7Banner - University Medical Center Tucson Campus Llc

Tucson, AZ · Clinic/Center, Multi-Specialty

$653K
81003989831$636K
9State Of Mississippi - University Of Mississippi Medical Center

Jackson, MS · General Acute Care Hospital

$452K
10The Cooper Health System

Camden, NJ · General Acute Care Hospital

$394K
11Best Option Healthcare Puerto Rico Llc

San Juan, PR · Pharmacy Home Infusion Therapy Pharmacy

$380K
121306883228$373K
13The General Hospital Corporation

Boston, MA · General Acute Care Hospital

$331K
14The Griffin Hospital

Derby, CT · Clinic/Center, Emergency Care

$314K
15Norton Hospitals Inc

Louisville, KY · General Acute Care Hospital

$303K
16State Of Connecticut

Farmington, CT · Counselor, Professional

$262K
171770586794$259K
18Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$224K
191144656364$213K
20Egleston Children's Hospital At Emory University Inc.

Atlanta, GA · Pediatrics Pediatric Emergency Medicine

$209K

Showing top 20 of 47 providers billing this code